Higher glucagon-to-insulin ratio is associated with elevated glycated hemoglobin levels in type 2 diabetes patients

Lee, Minyoung; Kim, Minkyung; Park, Jong Suk; Lee, Sangbae; You, Jihong; Ahn, Chul Woo; Kim, Kyung Rae; Kang, Shinae

doi:10.3904/kjim.2016.233

Cited by 22 publications

(26 citation statements)

References 42 publications

(46 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, we demonstrated that both fasting and postprandial glucagon-C-peptide ratios were positively associated with HbA1c and postprandial glucose, and a high glucagon-C-peptide ratio might predict that the risk of poor glucose control increased significantly. A Korean study, similar to this study, demonstrated that a high postprandial GI ratio, rather than fasting GI ratio, was positively associated with uncontrolled hyperglucose in patients naive to insulin use [8] . The underlying mechanism by which the glucagon-C-peptide ratio can predict glucose control may be that the glucagon-C-peptide ratio reflects overall pancreatic islet dysfunction [10] .…”

Section: Discussionsupporting

confidence: 75%

“…Emerging data have shed light on the fact that the GI ratio is a determinate of hyperglycemia in patients with type 2 diabetes [7] . A Korean study including subjects native to insulin treatment demonstrated that a high postprandial GI ratio was positively associated with glycosylated hemoglobin A1c (HbA1c) [8] . Similarly, in patients with pancreatic cancer, a high GI ratio after a 75-g oral glucose challenge was a surrogate marker of uncontrolled hyperglycemia [9] .…”

mentioning

confidence: 99%

See 1 more Smart Citation

High Glucagon-to-C-peptide Ratio and Inadequate Glucose Control in Type 2 Diabetic Patients

Lu¹,

Su²,

Wang³

et al. 2020

Preprint

View full text Add to dashboard Cite

Objective: Unbalanced glucagon and insulin secretion may contribute to glucose fluctuations and inadequate glucose control in type 2 diabetic patients. This study aimed to investigate the relationship between the glucagon-to-C-peptide ratio and glycemic control. Methods: From January 2017 to December 2018, a total of 1128 type 2 diabetic patients were recruited. The fasting and postprandial glucagon-to-C-peptide ratios were calculated following a 75-g oral glucose tolerance test (OGTT). Subjects were divided into quartiles based on their fasting and postprandial glucagon-to-C-peptide ratios. Statistical analysis was then carried out. Results: HbA1c levels were significantly and positively correlated with fasting (r = 0.333, p < 0.001) and postprandial glucagon-C-peptide-ratio (r = 0.373, p < 0.001). The proportion of patients with uncontrolled hyperglucose significantly increased from 76.2% to 83.0%, 89.4% and 94.7% from the first to second, third and fourth quartiles of the fasting glucagon-C-peptide ratio and increased from 73.4% to 80.9%, 93.3% and 95.7% from the first to second, third and fourth quartiles of the postprandial glucagon-C-peptide ratio, respectively. After adjusting for potential influences, the mean difference (95% CI) in HbA1c between the patients in the lowest and highest quartiles of the fasting glucagon-C-peptide ratio was 1.925 (1.512, 2.338) %, and the mean difference in HbA1c between the patients in the lowest andhighest quartiles of the prandial glucagon-C-peptide ratio was 2.401 (1.981, 2.820) %. After adjusting for possible metabolic risks by multiple logistic regression analysis, the corresponding odds ratios (ORs) for uncontrolled hyperglucose of the second, third and fourth quartiles versus the first quartile of fasting glucagon-C-peptide-ratiowere 1.331 (95% CI 0.829–2.136), 2.818 (1.647–4.823) and 7.268 (3.573–14.784), respectively. When compared with the first quartile of the postprandial glucagon-C-peptide ratio, the corresponding ORs for uncontrolled hyperglucose of the second, third and fourth quartiles were 1.752 (95% CI 1.100–2.793), 6.304 (3.348–11.560) and 15.998 (7.353–34.805), respectively. Conclusions: For type 2 diabetic patients, an increased glucagon-to-C-peptide ratio is associated with an increased risk of uncontrolled hyperglucose.

show abstract

Section: Discussionsupporting

confidence: 75%

mentioning

confidence: 99%

High Glucagon-to-C-peptide Ratio and Inadequate Glucose Control in Type 2 Diabetic Patients

Lu¹,

Su²,

Wang³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Consistent with a previous study, this study showed that higher postprandial GI ratio was positively correlated with HbA1c, FBG and HDL-C levels. 20,21 In patients with pancreatic cancer, GI ratio after a 75-g oral glucose challenge was independently correlated with HbA1c level. 22 In addition, appropriate choice of drugs for T2DM can be determined according to the glucagon response or change in absolute glucagon or GI ratio after glucose lowering drugs.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3]17 Previous studies have demonstrated that an increase in glucagon concentration and GI ratio reflects hyperglycaemia and degree of glycaemic control in individuals with T2DM. [18][19][20][21] Other studies have revealed a role of GI ratio in pancreatic cancer-related diabetes mellitus (DM). 22,23 Although glucagon relative to insulin is receiving much attention recently, there are little data regarding the association between GI ratio and NAFLD independent of insulin resistance in individuals with T2DM.…”

Section: Association Of Glucagon-to-insulin Ratio and Nonalcoholic Famentioning

confidence: 99%

Association of glucagon-to-insulin ratio and nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus

Moh

Jung

Lee

et al. 2018

Diabetes and Vascular Disease Research

View full text Add to dashboard Cite

The aim of this study is to investigate the association between glucagon-to-insulin ratio and the presence of nonalcoholic fatty liver disease on ultrasonography in participants with type 2 diabetes mellitus. Research design and methods: This cross-sectional study was performed with data obtained from 172 participants with type 2 diabetes mellitus admitted to a University hospital of Korea. Participants were assessed for serum fasting and postprandial serum glucagon-to-insulin ratio and divided into tertiles. Nonalcoholic fatty liver disease was defined as ultrasonographically detected fatty liver. Results: Prevalence of nonalcoholic fatty liver disease was significantly decreased across tertile of fasting and postprandial glucagon-to-insulin ratio (p = 0.009 for trend, p = 0.001 for trend, respectively). Lower glucagon-to-insulin ratio was significantly associated with the presence of nonalcoholic fatty liver disease even after adjustment for potential confounding variables [fasting glucagon-to-insulin ratio: odds ratio (95% confidence interval), 2.68 (1.08-6.86)], postprandial glucagon-to-insulin ratio: [2.72 (1.03-7.35)]. The participants in the lowest tertile of fasting glucagon-to-insulin ratio had higher body mass index, visceral fat thickness, subcutaneous fat thickness, homeostasis model assessment-insulin resistance and shorter duration of diabetes mellitus. Conclusion: This study suggests that lower glucagon relative insulin may be independently associated with nonalcoholic fatty liver disease in participants with type 2 diabetes.

show abstract

“…Nevertheless, α-cells cannot be underestimated because their function to release glucagon and stimulate the liver to produce glucose [2]. Dysregulation of α-cells results in fasting and postprandial hyperglycemia in T2DM [3] and is accompanied by a higher glucagon-to-insulin ratio and augmentation of the pancreatic α-to β-cell area ratio [4,5]. In addition, there is also increased glucagon concentrations in prediabetes [6].…”

Section: Introductionmentioning

confidence: 99%

Mesenchymal Stem Cell-conditioned Medium Alleviates High Fat-induced Hyperglucagonemia via miR-181a-5p and its Target PTEN/AKT Signaling

Song

Guo

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Pancreatic α-cells are critical to glucose homeostasis because they release glucagon and stimulate the liver to produce glucose. Dysregulation of α-cells gives rise to fasting and postprandial hyperglycemia in type 2 diabetes mellitus(T2DM). Mesenchymal stem cells (MSCs) or their conditioned medium can improve islet function and enhance insulin sensitivity in target tissues. However, studies showing the direct effect of MSCs on islet α-cell dysfunction are limited. Methods: In this study, we used high-fat diet (HFD)-induced mice and α-cell line exposure to palmitate (PA) to determine the effects of bone marrow-derived MSC-conditioned medium (bmMSC-CM) involved in glucagon secretion. To investigate the potential signaling pathways, phosphatase and tensin homolog deleted on chromosome 10 (PTEN) , AKT and phosphorylated AKT(p-AKT) were assessed by Western blotting.Results: In vivo, bmMSC-CM infusion protected against HFD-induced hyperglycemia and hyperglucagonemia. Consistently, bmMSC-CM decreased PA-induced glucagon secretion in α-cells and isolated islets. Additionally, bmMSC-CM reduced intracellular PTEN expression and rescued AKT signaling. Previous studies and the TargetScan database indicate that miR-181a and its target PTEN play vital roles in ameliorating α-cell dysfunction. We observed that miR-181a-5p is highly expressed in BM-MSCs but prominently lower in αTC1-6 cells. Overexpression or downregulation of miR-181a-5p respectively alleviates or aggravates glucagon secretion in αTC1-6 cells via the PTEN/AKT signaling pathway. Conclusions: Our observations suggest that MSC-secreted miR-181a-5p mitigates glucagon secretion of α-cells by regulating PTEN/AKT signaling. These findings might provide a novel understanding of MSC-based treatment.

show abstract

Higher glucagon-to-insulin ratio is associated with elevated glycated hemoglobin levels in type 2 diabetes patients

Abstract: Hyperglucagonemia relative to insulin could contribute to uncontrolled hyperglycemia in type 2 diabetes patients.

Cited by 22 publications

References 42 publications

High Glucagon-to-C-peptide Ratio and Inadequate Glucose Control in Type 2 Diabetic Patients

High Glucagon-to-C-peptide Ratio and Inadequate Glucose Control in Type 2 Diabetic Patients

Association of glucagon-to-insulin ratio and nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus

Mesenchymal Stem Cell-conditioned Medium Alleviates High Fat-induced Hyperglucagonemia via miR-181a-5p and its Target PTEN/AKT Signaling

Contact Info

Product

Resources

About

Higher glucagon-to-insulin ratio is associated with elevated glycated hemoglobin levels in type 2 diabetes patients

Abstract: Hyperglucagonemia relative to insulin could contribute to uncontrolled hyperglycemia in type 2 diabetes patients.

Cited by 22 publications

References 42 publications

High Glucagon-to-C-peptide Ratio and Inadequate Glucose Control in Type 2 Diabetic Patients

High Glucagon-to-C-peptide Ratio and Inadequate Glucose Control in Type 2 Diabetic Patients

Association of glucagon-to-insulin ratio and nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus

Mesenchymal Stem Cell-conditioned Medium Alleviates High Fat-induced Hyperglucagonemia&nbsp;via miR-181a-5p and its Target PTEN/AKT Signaling

Contact Info

Product

Resources

About

Mesenchymal Stem Cell-conditioned Medium Alleviates High Fat-induced Hyperglucagonemia via miR-181a-5p and its Target PTEN/AKT Signaling